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2010-336 TOWN OFQ UEENSBURY wow742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20100336 Date Issued: Thursday, April 25, 2013 This is to certify that work requested to be done as shown by Permit Number P20100336 has been completed. Tax Map Number: 523400-240-000-0001-014-000-0000 Location: 2397 RIDGE Rd Owner: EDWARD HOOKER Applicant: EDWARD & METTA HOOKER TRUST This structure may be occupied as a: Septic Alteration Residential By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, / Variance, or other issues and conditions as a result of approvals by the itGA Director of Building&Co•e Enfo ement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100336 Application Number. A20100336 Tax Map No: 523400-240-000-0001-014-000-0000 Permission is hereby granted to: EDWARD &METTA HOOKER TRUST For property located at: 2397 RIDGE Rd in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: EDWARD &METTA HOOKER TR 2397 RIDGE Rd Septic Alteration Residential QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-336 SEPTIC ALTERATION RESIDENTIAL $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,July 15,2011 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the yef Quesbu ' 3iureday,July 15, 2010 ,+ 3 SIGNED BY s,l'`_ for the Town of Queensbury. Director of Building&Code Enforcement For an EPA homeowner's guide: htto://www.ela.gov/nodes/pubs/homeowner guide long customize.odf 24 / �! OFFICE USE ONLY • TAX MAP Na PERMIT NO. /07-1--56 PERMIT FE APPROVALS: ZONING TOWN CLERK •• ti APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: ,LI &2 1) OOb( J INSTALLER: • - _ KG. ADDRESS: 2.a97 � Y ADDRESS: ears � '79'5 PHONE NOS. CQS —Cie'"T Y PHONE NOS. Zq s5— 00-Nct j LOCATION OF INSTALLATION: Z.--S97 ;DCaE RESIDENCE YEAR BUILT NO.OF X COMPUTATION= = TOTAL DAILY FLOW INFORMATION: BEDROOMS 1980 or older X 150 gallon per bedroom = 0 GARBAGE GRINDER INSTALLED? 11C 1981 -1991 3 X 130 gallon per bedroom = 0 1992-present X 110 gallon per bedroom = 0 SPA OR HOT TUB INSTALLED? 114.c PARCEL INFORMATION: / ✓ TOPOGRAPHY: FLAT ROLLING % STEEP SLOPE SLOPE 0-3% ✓ SOIL NATURE: SAND V LOAM ✓ CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? > I ~ v �j BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH?_3C0—� I DOMESTIC WATER SUPLY: ♦fr _ MUNICIPAL WELL (If well:water supply from any septic system absorption is:(Z'S ft) -5014 N.)AZt A+d.0-t- C f,�9c� Cn./Z�/t ✓ PERCOLATION TEST: RATE IS 5 PER MIINUTE PER INCH(TEST TO BE COMPLETED BY A LICE SED PROFESSIONAL ENGINEER OR ARCHITECT) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). TANK SIZE: ►000 GALLON (MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. SYSTEM TYPE: ABSORPTION FIELD(WITH NO. 2 STONE) Total length I(Q7 ft. Each trench `17'' X 3 ❑SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? El ALTERNATIVE SYSTEM Bed or other type? El HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury,any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree QUESTIONS? CALL 761-8256 OR EMAIL to abide by these and all requirements of the Town of Queensbury codesRDqueensburv.net Sanitary Sewage Disposal Ordinance. VISIT OUR WEBSITE FOR MORE INFORMATION www.queensburv.net —a—CO—10 ature of Person Responsible Date diTown of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 RESOLUTION APPROVING EDWARD HOOKER'S APPLICATION FOR SANITARY SEWAGE DISPOSAL VARIANCES RESOLUTION NO.: 16,2010 BOH INTRODUCED BY: Mr.John Strough WHO MOVED ITS ADOPTION SECONDED BY: Mr. Ronald Montesi WHEREAS, Edward Hooker submitted an application for variances from provisions of the Town of Queensbury On-Site Sewage Disposal Ordinance, Chapter 136 to allow install: 1. an absorption field 75' from the existing well instead of the required 100' setback; 2. an absorption field 16' from the existing dwelling instead of the required 20' setback; and 3. a distribution box 82' from the existing well instead of the required 100' setback; on property located at 2397 Ridge Road in the Town of Queensbury, and WHEREAS, the Town Clerk's Office published the Notice of Public Hearing in the Town's official newspaper and the Local Board of Health duly conducted a public hearing concerning the variance requests on Monday, June 21st,2010, and WHEREAS, the Town Clerk's Office has advised that it duly notified all property owners within 500 feet of the subject property, NOW, THEREFORE,BE IT RESOLVED,that 1. due to the nature of the variances, the Local Board of Health determines that the variances would not be materially detrimental to the purposes and objectives of this Ordinance or other adjoining properties nor otherwise conflict with the purpose and objectives of any Town plan or policy; and 2. the Local Board of Health finds that the granting of the variances is necessary for the reasonable use of the land and is the minimum variances which would alleviate the specific unnecessary hardship found by the Local Board of Health to affect the applicant; and BE IT FURTHER, RESOLVED, that the Local Board of Health hereby approves Edward Hooker's application for a variance from the Sewage Disposal Ordinance to install: 1. an absorption field 75' from the existing well instead of the required 100' setback; 2. an absorption field 16' from the existing dwelling instead of the required 20' setback; and 3. a distribution box 82' from the existing well instead of the required 100' setback; 4. once a year for the next two years this system will be checked for leakage, by sampling the water for e-coil on property located at 2397 Ridge Road in the Town of Queensbury, and bearing Tax Map No.: 240.-1-14. Duly adopted this 21St day of June, 2010,by the following vote: AYES : Mr. Montesi,Mr. Strough,Mr. Brewer,Mr. Stec,Mr. Metivier NOES : None ABSENT: None 2 Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/am Depart: . am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:/' . /� (�M� NAME: �- %� 1�� PERMIT NO.. 3 LOCATION: Rj ck i.7 Red INSPECT ON: 31: RECHECK: / Comments and/or diagram Soil Type: Sand/ Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' +/ - Y N N/A [150'to well required if NO] Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: Y—N End Cap Y„^ N Inlet/Outlet Pipes&Baffles Y T N Manholes 12"or less below grade _Y_N [provide extension collar if Yes] _._Y—N441711" ,� rt Location/ Separations Foundation to tank ft. Foundation to absorption 1 ft. A-3 Separation of Pits ft. Conforms as per Plot Plan Y_N Engineer Report and As-Built ;Y^N ETU Maintenance Contract _Y_N provided Location of System on Property: Front R-. Left Side Right Side Middle Front Middle Rear S tem U - S App . • • al Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Reportj03 29 10.doc Ilik /0:00 - tkli, ,zie Septic Inspection Report ` Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: Oft(' am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: Z__./ A,„19 NAME: l; . ` ♦'et— PERMIT NO.: LOCATION: "-3 7 , /, .- INSPECT ON: i_2---/b RECHECK: ,...,-1- Comments and/or diagram Soil Type:(SaAH/ oap/Clay Type of Water: Municipal/ Nell Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A [150'to well required if NOl _ ç:;.-ii2__ M)1/4-'- ') Absorption Field: Total length ft. trda50,2i-z..44,.....,- Length of each trench ft. Depth of trenches /Box 4--- Size rSize of Stone .?2- g — `01`- Seepage Pits: Number Size: �"' Stone Size: t�?� Piping Size Type Building to tank L .\S.',11-<.,0 1-44<... Tank to Distribution Box 'r -re-1, -3 Distribution Box to Field/ Pit .4' QT).-. Opening Sealed: ,Y N End Cap t/Y N t 1 Inlet/Outlet Pipes&Baffles Y Nf-flei Manholes 12"or less below grade Y`N -— [provide extension collar if Yes] Y N PlC' ....---- Location/ Separations Foundation to tank ft. Foundation to absorption ft. --7-5-6E--- Pt-41,-Ki Separation of Pits ft. -.Conforms as per Plot Plan . Y N Engineer Report and As-Built —Y N ETU Maintenance Contract Y N provided Location of System roperty: Front Rear Left Side Right Side Middle Front Middle Rear t-m i .t . Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiiting\2010\Building Codes Forms\Inspecdon Forms\Septic Inspection Report_03 2910.doc /2 200 IAJytitAc_-_ - 11 Septic Inspection Report Office No. (518)761-8256 Date Insmctiormequest received: Queensbury Building&Code Enforcement Arrive: ( J-' Vam rt: am/pm 742 Bay Rd., Queensbury, NY 2804 Inspector's Inils: NAME: L► ) _ PERMIT NO.: ,.• LOCATION: "' ` INSPECT ON: - _ - RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/Clay Type of Water: Municipal/Well Water . 6 tL pr 6 'ft "L� Waterline separation distance ft. Well separation distance ft. K Other wells: ft. Well Casing Length 50' +/- Y N N/A [150'to well required If NO] c- Absorption Field: Total length ft. GSC - ( 13 Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: —N End Cap Y N Inlet/Outlet Pipes&Baffles Y_N Manholes 12"or less below grade _Y N [provide extension collar if Yes] Y—N Location/Separations Foundation to tank , ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Pian _Y �/n� I/4 Engineer Report and As-Built Y N tp\I t C— E A)6- >'`f'P o �-- ETU Maintenance Contract Y N provided r Location of Sy - Property: Front Left Side Right Side Middle Front Middle Rear em - S Approved r Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Focros\Sepdc Inspection Report_03 29 10.doc 4A0 Jc4_ rvuittk aB ? g_120, re_o C),„,„A.1.7 AK )/ (S 2_ 1 1Les4 7. Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Rd., Queen bury, NY 12804 Inspector's Initials: / --IC NAME: • _ cam" _ . �.-.V�� � .i1 PERMIT NO.: LOCATION: •r �i`+��.� Cw INSPECT ON: - 0 RECHECK: Comments and/or diagram Soil Type:r / Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distanceft. Other wells: ft. Well Casing Length 50'+/- - Y N N/A [150'to well required if NO] Absorption Field: Total length ft. Length of each trench ft. Depth of trenches /0 1 Size of Stone (/ /7_,, TA-4-2, 1-tket,,__. Seepage Pits: Number Size: Ci-tr-L._. 1, - Stone Size: i LA17E14444_— Piping Size Type Building to tank - Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: N End Cap Y N Inlet/Outlet Pipes&Baffles Y—N z 1a 'Z Manholes 12"or less below grade _Y N [provide extension collar if Yes] Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N `'12-- Engineer Report and As-Built Y N ETU Maintenance Contract Y N provided Location of System roperty: Front Rear Left Side Right Side Middle Front Middle Rear 518g11-11,51Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Farms\Inspection Fomis\Septic Inspection Repork_03 29 10.doc oN dblN xsz wdDi-1a aooa'u=aa 6Mattxeu\xa07e 371,1\sxa07a ovav\000zc°—\:a a g �c) ' r.. 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